Acute vs. Chronic Hepatitis C: What’s the Difference?

Without treatment, chronic hepatitis C can cause damage to the liver over time. Scarring on the liver (cirrhosis) increases the risk of liver cancer and liver failure. Unfortunately, many people do not detect hepatitis C when it’s in the acute stage — when it’s generally easier to treat.

What is acute hepatitis C?

Acute hepatitis C refers to an active infection that is typically detected within the first six months. Effective treatments may help get it under control, such as direct-acting antiviral medication. Some people may be able to suppress the infection with their own immune system.

During the acute stage, hepatitis C is less likely to cause long-term damage to the liver. This is important since your liver plays many roles in your health, such as digesting food, removing harmful toxins or poisons from the digestive system, and storing energy.

Not everyone with hepatitis C has symptoms, which is what makes it hard to catch in the early stages. For people who do notice acute hepatitis C symptoms, they may include:

• Nausea

• Change in the color of urine or stool

• Fever

• Flu-like symptoms

What is chronic hepatitis C?

Chronic hepatitis C is an infection that lasts more than 6 months. This means that you haven’t been able to suppress the infection to undetectable levels by medication or your immune system. Many people who have chronic hepatitis C likely were not diagnosed with the infection when it was in the acute stage.

Why is chronic hepatitis C dangerous?

The longer you live with chronic hepatitis C, the more damage it is likely to do. First, the inflammation in the area may cause liver scarring, known as cirrhosis. This causes cells in the liver to not function as well as they should. Liver scarring can also increase the risk of liver cancer. 

Cirrhosis may progress until the entire liver is not working. This is called liver failure (or end-stage liver disease). 

How do doctors treat hepatitis C?

Healthcare providers generally treat acute and chronic hepatitis C the same way. The treatment for this infection is called direct-acting antiviral medication. These medications are usually very effective, easy to take, and cause few side effects. 

The treatment for hepatitis C takes about eight to 12 weeks. The vast majority of people who take direct-acting antiviral medications have undetected virus levels within six months.

If hepatitis C has progressed to liver failure, treatment may depend on a liver transplant. That’s because you cannot live without a functioning liver.

Talk to your doctor to learn more information about testing guidelines for hepatitis C. All adults should receive at least one hepatitis C test in their lifetime, but if you have certain risk factors, you may need additional testing.

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Written by:

Lauren Smith, MA

Lauren Smith, MA, has worked in health journalism since 2017. Before joining GoodRx, she was the senior health editor and writer for HealthiNation.

Reviewed by:

Alexandra Schwarz, MD

Alexandra Schwarz, MD, is a board-eligible sleep medicine physician and a board-certified family medicine physician. She is a member of both the AASM and the ABFM.

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